Understanding how a herniated disc develops requires abasic understanding of the intervertebral disc itself. A discis made up of two components: the annulus fibrosus andthe nucleus pulposus. The annulus fibrosus is the wall oftough fibrocartilage (made of concentric layers calledlamellae) that contains the nucleus pulposus, which is thedisc’s gelatinous center. The nucleus pulposus is primarilymade of water, protein, and collagen. Together, theannulus fibrosus and the nucleus pulposus provide ahighly pressurized, shock-absorbent cushion thatseparates and connects adjacent vertebrae while lendingflexibility to the spine.
How an Intervertebral Disc DegeneratesAn intervertebral disc, just like any other part of the body, is prone to degeneration. Theintervertebral discs in the lower back (lumbar spine) and neck (cervical spine) are especially proneto deterioration because they are tasked with supporting the weight of the upper body andhead, respectively, and also facilitating the spine’s many movements. Over time, the nucleuspulposus can lose water and collagen while the annulus fibrosus loses elasticity. The nucleuspulposus may press against the weakened disc wall and cause it to bulge out to one side (a bulgingdisc), or a tear may develop in the annulus fibrosus (a herniated disc).There are a variety of underlying causes of disc degeneration, a few of which are: • Age • Genetics • Injuries • Poor posture • Smoking • Repetitive stress
Herniated Disc SymptomsIn some cases, a herniated disc remains completely asymptomatic.However, if the nucleus pulposus leaks through the rupture in thedisc’s wall, it can either irritate nerve endings inthe wall or spread into the spinal canal and presson a nearby spinal nerve root or the spinal cord.When this happens, the following symptomsmay develop in the neck, back,and/or extremities: • Shooting pain • Tingling • Numbness • Muscle weakness
Getting a Professional DiagnosisIf you think you may be suffering from a herniated disc, itis extremely important to get a professional diagnosisfrom a medical professional before starting any kind oftreatment plan. You can start by scheduling a consultationwith your primary care physician, who will likely conducta physical examination, ask you about yoursymptoms, and review your medical history. He or shemay also order medical imaging tests like an X-ray, MRI, or CT scan. If your physician is unable to confirma diagnosis at this point, you may be referred to a spinespecialist for further testing.
Herniated Disc TreatmentIn the event that a herniated disc diagnosis is confirmed by your primary care physician or a spinespecialist, the initial approach to treatment will most likely be nonsurgical, or conservative, innature. Common treatments for a herniated disc in the neck or back include pain medication likeanalgesics or non-steroidal anti-inflammatory drugs, physical therapy, hot/coldcompresses, gentle stretching, or low-impact exercise. More targeted pain managementtechniques are sometimes necessary, such as corticosteroid injections, ultrasoundtherapy, prolotherapy, or transcutaneous electrical nerve stimulation (TENS). Some patients alsochoose to explore different forms of complementary and alternative medicine for the treatmentof a herniated disc, including yoga, massage, acupuncture, and herbal supplements.However, before integrating any types of alternative therapies into your prescribed regimen oftreatments, be sure talk with your doctor.Surgery for a herniated disc is generally only necessary in rare cases when weeks or months ofconservative treatments have proven ineffective. Several different types of surgery are availableto relieve neural compression associated with a ruptured disc, including open spine surgeries andminimally invasive surgeries, but not all patients will be candidates for all types of treatment.Before consenting to elective surgery of any kind, be sure that you have tried a wide range ofconservative treatments and gotten multiple opinions from various spine surgeons.